Long-term persistence of knee pain and occupational exposure in two large prospective cohorts of workers

Assessment of occupational musculoskeletal disorders (MSDs) among heavy vehicle drivers

BACKGROUND

Professional driving requires long hours of work, uncomfortable seats, negotiating rough terrain and highways, and possibly minor repairs and other auxiliary transportation duties. Heavy vehicle drivers driving vehicles such as trucks, bulldozers, etc. due to such working structures are more prone to various musculoskeletal disorders (MSDs) and pain, which is of great concern.

OBJECTIVES

In the present study, it is planned to investigate possible ergonomic risk factors such as age, weight, driving exposure, seat suspension systems, lifting heavy weights causing MSDs in drivers of various heavy vehicles. The results of the study are expected to help drivers reduce the risk of MSDs.

METHODS

For the present study, the Nordic questionnaire on musculoskeletal disorders was modified and standardized and was administered to the 48 heavy vehicle drivers randomly selected to collect the data.

RESULTS

The analysis divulged that over the past 12 months, lower back pain (LBP) emerged as the most dominant pain experienced by 56% of drivers, followed by knee pain (KP) (43%) and neck pain (NP) (39%) respectively. The prevalence of shoulder pain (SP) was observed to be much lower than in previous literature. The logistic regression model further revealed that increasing age, poor suspension system and poor body posture were significantly associated with lower back pain. Additionally, a poor suspension system and lifting heavy weights had significant effect on the drivers' knee pain.

CONCLUSION

The results demonstrated the evident necessity for ergonomic consideration in vehicle designing and ergonomic training for heavy vehicle drivers.

Permanent Unfitness for Work and Musculoskeletal Diseases: A Multicentric Cross-sectional Study of 2788 Unfit Employees

OBJECTIVE

To describe the various musculoskeletal diseases resulting in work-related permanent unfitness for work. Methods: In 2017, a multicenter cross-sectional employee survey in the South of France was conducted by 323 occupational physicians. Results: Of the 359,966 employees monitored, 2788 had permanent unfitness for work. This number included 1078 for musculoskeletal diseases, which was more frequent in women (odds ratio, 1.42; confidence interval, 1.20 to 1.68) and showed an increase in women older than 55 years (odds ratio, 6.42; confidence interval, 4.4 to 6.60). Back disorder was the most common work-related disorder reported (n = 488 [45.4%]), with soft tissue conditions being (n = 237 [22.0%]). Arthropathy (n = 157 [14.6%]) had occupational origins in 282 (44.3%), 169 (26.6%), and 55 (8.6%) cases, respectively. Conclusions: Musculoskeletal disability prevention should be encouraged to avoid resultant employment attrition.

Prevalence and associated factors of lower extremity musculoskeletal disorders among manufacturing workers: a cross-sectional study in China

OBJECTIVE

To survey the prevalence of lower extremity musculoskeletal disorders (MSDs) among Chinese manufacturing workers, and to identify the associated factors.

DESIGN

Observational study with cross-sectional design.

SETTING

A self-administered questionnaire survey was conducted in four manufacturing factories in China.

PARTICIPANTS

7908 manufacturing workers were included in this study after excluding non-conforming personnel.

OUTCOME MEASURES

Individual and work-related information, and MSDs in the whole leg and knee region were measured by the anonymous self-administered questionnaire. Individual and work-related factors associated with MSDs and their effects were identified through multivariate logistic regression.

RESULTS

Of all respondents, 3241 (41.0%) reported having had lower extremity MSDs in the recent 12 months, and for the knees, ankles/feet and hips/thighs were 29.5%, 23.9% and 16.7%, respectively. After confounder-adjusted single-factor analysis, 22 variables (of 24) were significantly related to the disorders. Factors like always kneeling/squatting for long periods, always standing for long periods and often lifting in an uncomfortable position were shown to have higher risks, with ORs of 2.77 (95% CI: 2.33 to 3.30), 2.30 (1.96 to 2.69) and 2.25 (2.04 to 2.47). Comparable results were found on knee disorders. The final model included 15 variables of demography, biomechanics and work organisation. The following factors showed increased risks of lower extremity MSDs: being female, being older, longer working years, higher body mass index (BMI), keeping the same posture for a long time, awkward position, shift work and monotonous work. Whereas having enough breaks reduced the risk.

CONCLUSION

The prevalence of lower extremity MSDs among Chinese manufacturing workers is high. The most commonly affected body regions were the knees and ankles/feet. Multiple factors were found associated with lower extremity MSDs including age, BMI, work experience, work organisations, physical ergonomics exposures, etc.

Physical Work Demands of Childcare Workers in Denmark: Device-Based Measurements and Workplace Observations Among 199 Childcare Workers from 16 Day Nurseries

Objectives

Childcare workers in Denmark have high prevalence of musculoskeletal pain (MSP) and sickness absence, but the existing knowledge of their physical work demands is limited, hampering preventive initiatives. This study aimed to assess the physical work demands with accelerometers and workplace observations of childcare workers handling children age 0–3.

Methods

Data collection consisted of an electronic survey, anthropometric measurements, accelerometer measurements providing information of physical activity types and postures with Acti4 software from five consecutive workdays, as well as 4-h visual workplace observation per childcare worker from 16 Danish nurseries.

Results

In total, 199 childcare workers were enrolled in the study. A total of 4181 working hours of accelerometer measurements and 722 h of workplace observations were carried out. Accelerometer measurements showed that they spent about half of the working day (44.8%) in sedentary postures, and the rest standing (22.8%), moving (13.0%), walking (14.6%), running (0.1%), and climbing stairs (0.7%), with 4.1% in knee straining postures (kneeling and squatting) and 4.3% forward trunk inclination >60°. Workplace observations showed that they carried children 1.8% of the working hours.

Conclusions

Physical work demands of Danish childcare workers are characterized by about half of the workday being sedentary, and the remaining of the workday being quite evenly distributed between standing and dynamic activities, with low exposures to carrying children. Their exposure to forward bending of the trunk and knee straining postures could impose a risk for MSP and sickness absence, and preventive initiatives should be considered.

Detection of kneeling and squatting during work using wireless triaxial accelerometers

Occupational kneeling and squatting are well-documented risk factors for knee disorders. A method using 3 wireless accelerometers to detect and discriminate kneeling and squatting during work were developed based on data from a semi-standardised laboratory protocol. The method was tested for validity under free-living working conditions. The developed method showed high sensitivity (88-99%) and specificity (98-99%) for detection of kneeling and squatting during the semi-standardised laboratory conditions. During free-living working conditions, kneeling showed very high sensitivity (94%) and specificity (99%), while squatting results were non-conclusive due to limited duration of squatting during the free-living working conditions. This method shows great promise for long-term technical measurement of kneeling and squatting during normal working conditions using wireless accelerometers. The method opens up possibilities for using technical measurements to provide valid exposure assessments and intervention evaluations of kneeling and squatting, as well as increased feasibility for technical measurements in large cohort studies. Practitioner summary: Quantification of kneeling and squatting during work is important for prevention, but limited by either imprecise or costly methods. This study developed and validated an inexpensive wireless accelerometer-based measurement method that can be used by practitioners and researchers for long-term measurements of kneeling and squatting during free-living working conditions.

Knee pain in nursing home workers after implementation of a safe resident handling program

PURPOSE

Approximately 25-30% of nursing personnel experience knee pain (KP). We sought to identify physical and psychosocial work exposures, and personal factors related to prevalent, incident, and persistent KP 5-8 years after safe resident handing program (SRHP) implementation in nursing homes.

METHODS

Health and exposure information was obtained from worker surveys 5-6 years ("F5") and 7-8 years ("F6") post-SRHP implementation. Prevalent KP correlates were examined at F5; persistent and incident KP predictors were analyzed at F6, utilizing robust Poisson multivariable regression.

RESULTS

F5 KP prevalence (19.7%) was associated with combined physical exposures, and with either high job strain or low social support, in separate models. Two-year persistent KP was similarly associated with these psychosocial exposures. Being overweight was associated with KP in all analyses.

CONCLUSIONS

The SRHP program did not eliminate knee physical loading, which should be reduced to prevent nursing home worker KP. Workplace psychosocial exposures (high job strain, low social support) also appeared germane.